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Ambulatory Reflux Monitoring in GERD – Which Test Should be Performed and Should Therapy be Stopped?

  • Esophagus (L Gerson, Section Editor)
  • Published:
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Abstract

Diagnosing gastroesophageal reflux disease (GERD) often entails using a combination of patient symptoms, response to proton pump inhibitors (PPI), upper endoscopy, and ambulatory reflux testing. Each of these has limitations of which the clinician must be aware when managing patients with reflux symptoms. Ambulatory reflux monitoring, in particular, can potentially document the true presence of pathologic GERD. Consequently, reflux testing is often necessary in our evaluation of patients with reflux symptoms, and can be useful in distinguishing etiologies driving a lack of response to PPI therapy. Reflux testing results can be also used to guide appropriate PPI prescribing and clinical decision making for appropriate or unnecessary therapy. This review focuses on the limitations of our current diagnostic paradigm and highlights how reflux testing can be helpful in the diagnosis and management of patients with poor response to PPI therapy.

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Acknowledgments

This work was supported by R01 DK079902 (JEP) from the Public Health Service. Dr. Gawron is supported by a NRSA award from the Agency for Research and Quality, T-32 HS 000078 (PI: Jane L Holl, MD MPH).

Conflict of Interest

John E. Pandolfino has been a consultant for Given Imaging. Andrew J. Gawron declares that he has no conflict of interest.

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Authors and Affiliations

  1. Department of Medicine, The Feinberg School of Medicine, Northwestern University, 676 St Clair St, Suite 1400, Chicago, IL, 60611-2951, USA

    Andrew J. Gawron & John E. Pandolfino

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  1. Andrew J. Gawron
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  2. John E. Pandolfino
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Correspondence to John E. Pandolfino.

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This article is part of the Topical Collection on Esophagus

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Gawron, A.J., Pandolfino, J.E. Ambulatory Reflux Monitoring in GERD – Which Test Should be Performed and Should Therapy be Stopped?. Curr Gastroenterol Rep 15, 316 (2013). https://doi.org/10.1007/s11894-013-0316-6

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  • DOI: https://doi.org/10.1007/s11894-013-0316-6

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